2022 | Coronavirus

Local hospitals not in dire straits, but face staffing shortages, influx of patients

Officials urge residents to stay vigilant with hospitalizations rising since early December

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Centers for Disease Control and Prevention

With hospitalizations in Montgomery County slightly increasing in recent months, officials say the outlook is not as dire as in other parts of Maryland. But they’re still concerned about the coming weeks, especially as patient intake has increased and staffing shortages persist. 

During a news briefing with reporters Wednesday, Assistant Chief Administrative Officer Earl Stoddard said he and Sean O’Donnell, the county’s public health emergency preparedness manager, were briefed by hospital officials last Friday.

Hospitals are in “fairly bad shape” for multiple reasons, Stoddard said — ranging from staffing shortages to the influx of patients, both because of the coronavirus and for other reasons.

According to the county’s COVID-19 dashboard, transmission of the coronavirus remains at some of the highest levels of the pandemic. As of Thursday, there were 1,922.4 cases per 100,000 residents during the past seven days, and a 25.7% positivity rate over the last seven days.

The dashboard shows that 84.6% of the county’s intensive care unit beds are being used, defined as “moderate utilization.” The county has been at that level since Jan. 6.

It also shows that 36% of hospital beds are occupied by patients with COVID-19, defined as “high utilization.”

Stoddard and other health officials, however, have said that statistic can be misleading because of “incidental cases” — meaning that some patients are taken to the hospital for another reason, like a car crash, and test positive when admitted there.

Stoddard said Wednesday it is difficult to gauge the situation in hospitals based on data alone. While there are fewer severe cases than in earlier waves of the pandemic, hospital staffs are still dealing with a significant influx of patients. 

“The [health] outcomes are a bit better, but if you just surge a hospital to a certain point with more patients, and then you take away more staff, you get to points — and they’re not necessarily constant points — where there are real pressures on getting people in and through an emergency department,” Stoddard told reporters.

Wait times for patients and emergency medical service crews waiting to get into local hospitals have been hours in some cases, he added.

O’Donnell said it’s important to look at the current hospital landscape through a “qualitative” versus “quantitative” lens. Emergency planning does not typically account for patient surges that last weeks or months, he said.

“It’s one thing to talk about surging for 24, 48 hours or even a few days,” O’Donnell said. “But doing this on an ongoing basis prevents unique challenges.”

Clinicians are now seeing more patients in hospital settings, staff members are being exposed to the coronavirus and there is more changing of personal protective equipment in between patients, which are all affecting the level of care, he added.

Even with the increase in patients, a few hospital officials did not say they were shifting to “crisis mode,” as seen in places like Frederick County. In Frederick, record hospitalizations have caused hospital officials to redirect staff to where there is most need, expediting discharges when appropriate and delaying elective surgeries when possible.

“Maryland is facing the worst COVID-19 surge since the pandemic began nearly two years ago,” the Maryland Hospital Association said in a statement on Tuesday. “The number of COVID-19 patients in hospitals across the state has nearly doubled in the last two weeks, and Maryland hospitals are virtually full.”

The association’s statement says Maryland hospitals were treating 3,452 COVID-19 patients as of Monday — about 1,500 more than the previous peak, one year earlier.

Carolyn Carpenter, the president of the Johns Hopkins Health System in the National Capital Region, wrote in an email that at Suburban Hospital in Bethesda, staffing levels remain “sufficient” to serve the community.

“We prioritize care for our sickest patients and have rescheduled elective surgical cases intermittently to assure we have the staff, beds, and other resources needed to manage the needs of our patients,” Carpenter wrote.

She added that clinicians have noticed the pace of infections, but they remain confident about being able to care for patients.

Carpenter called on residents to get vaccinated and boosted against the coronavirus, wear masks, social distance and practice good hand hygiene to curb the spread of the virus. 

Samantha Thompson, a spokeswoman for Holy Cross Health, agreed that residents need to remain vigilant during the current wave. She said elective surgeries are still happening at its hospitals in Germantown and Silver Spring.

“The community can trust that we are open, ready and safe for their emergent and scheduled acute care [needs], including scheduled surgeries,” Thompson wrote. 

Tina Sheesley, a spokeswoman for Adventist HealthCare Shady Grove Medical Center, wrote in an email that Shady Grove Medical Center in Rockville and White Oak Medical Center in Silver Spring are experiencing staffing shortages, but can sufficiently care for patients. 

Both hospitals have “paused a small segment of elective surgeries” to keep more in-patient beds open, Sheesley wrote.

“Adventist HealthCare has not moved to crisis standards of care,” she wrote. “Our leaders are closely monitoring staffing, bed capacity and supplies, which are the three areas that determine whether crisis standards of care should be implemented.”

She echoed Carpenter’s call to community members to take actions to curb the spread of the virus.  

“Our caregivers are tired,” Sheesley wrote. “Many are in disbelief that hospitals are back to caring for the number of COVID cases we saw at the start of the pandemic. Yet, they are dedicated to caring for patients and to seeing the community through these surges. The hospitals need our community’s support.”

Steve Bohnel can be reached at steve.bohnel@bethesdamagazine.com